Associate Quality Control

As an Associate in the Managed Services team at our company, you will have the opportunity to collaborate with various teams to assist clients in implementing new capabilities, achieving operational efficiencies, and leveraging technology. Specifically, in our Revenue Cycle Managed Services team, you will support healthcare clients in their revenue cycle functions, specializing in front, middle, and back-office revenue cycle operations. By utilizing custom and automated workflow solutions, you will help clients achieve better results and enhance patient care delivery. In order to align with the evolving landscape, it is essential for every individual at our company to embody purpose-driven and values-oriented leadership. Through our PwC Professional framework, we establish consistent expectations and skill requirements across different roles and geographies to enable career progression and success. Key Responsibilities: - Conduct quality control audits of patient accounts for Revenue Cycle Managed Services (RCMS) - Review and monitor accounts, identify issues, analyze trends, and make improvement recommendations - Provide daily feedback based on account notation - Collaborate with Continuous Improvement Specialist to resolve quality and efficiency issues - Document analysis findings, prepare reports, and recommend implementation of changes - Participate in quality control meetings and assist in assessing training needs - Demonstrate leadership skills, promote trust, encourage innovation, and provide feedback to staff - Maintain a positive attitude, communicate effectively, and contribute as a team player - Utilize in-depth knowledge of hospital revenue cycle, healthcare billing, and account resolution processes Qualifications Required: - Bachelor's Degree in Computer Science, Data Analytics, or Accounting - 2-4 years of experience in medical collections, billing, claims, and customer service - Experience in US Healthcare Commercial and Managed Care Insurance Claim Management/Billing/Claim Edit Resolution - Familiarity with US Healthcare Medicare and Medicaid Insurance Claim Management/Billing/Claim Edit Resolution - Proficiency in US Healthcare Denials Management (technical and clinical) - Ability to work flexible night shifts in the US time zone Additional Company Details: - The Quality Control Analyst role involves ensuring company and client standards are maintained in revenue cycle operations. This position requires identifying problems, analyzing trends, and collaborating with the Continuous Improvement Specialist to enhance quality and efficiency on projects. Strong communication, leadership, and analytical skills are essential for success in this role.,